Organization
SERENITY SAFE HAVEN OUTPATIENT CLINIC
Active
Parent organization
AGAPE STORGE HEALTHCARE SERVICES
Organization subpart
Yes
Provider details
NPI number
Legal business name
AGAPE STORGE HEALTHCARE SERVICES
Authorized official
TAHIRA S DOCKERY CRNP (CO-FOUNDER)
(267) 808-8810
Entity
Organization
Contact information
Practice address
8410 BUSTLETON AVE STE 2, PHILADELPHIA, PA 19152-1924
(267) 808-8810
Mailing address
93 OLD YORK RD STE 1-526, JENKINTOWN, PA 19046-3925
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
SP011319
PA
Other
Enumeration date
10/27/2014
Last updated
10/27/2014
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